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Biomedical subjects

P Pulido

Publications and source records attributed to P Pulido.

13 recordsLinked to original sources
PubMed2004

Web-based diabetes control.

We developed a diabetes management system with a Web interface that allowed patients to transmit their physiological data using either a PC Web browser or a mobile phone capable of working with the WAP protocol. The system could generate automatic responses to input values in accordance with a set of ranges previously defined for each user. User analysis was carried out with personal and online questionnaires. During a nine-month study period on the island of Tenerife, 12 patients were recruited. On average, they used the system every 2.0 days (SD 2.1) and the doctors reviewed their patient data every 4.0 days (SD 3.9). The average number of visits to the Website was 477 per month. Users were satisfied with the continuity and self-efficacy of care, but lack of time was a drawback for 38% of them and 75% expressed a preference for sending their data via the mobile phone short message service (SMS).

Adult↗
PubMed2004

Mobile phone text messaging in the management of diabetes.

We conducted a trial of mobile phone text messaging (short message service; SMS) for diabetes management. In an eight-month period, 23 diabetic patients used the service. Patients used SMS to transmit data such as blood glucose levels and body weight to a server. The server automatically answered with an SMS acknowledgement message. A monthly calculated glycosylated haemoglobin result was also automatically sent to the patient by SMS. During the trial the patients sent an average of 33 messages per month. Although users showed good acceptance of the SMS diabetes system, they expressed various concerns, such as the inability to enter data from previous days. Nonetheless, the trial results suggest that SMS may provide a simple, fast and efficient adjunct to the management of diabetes. It was particularly useful for elderly persons and teenagers, age groups that are known to have difficulty in controlling their diabetes.

Adolescent↗
PubMed2004

[Intracranial and spinal subdural hematoma: a rare complication of epidural and subarachnoid anesthesia].

Subdural and epidural hematomas complicating central blocks are rare but serious complications that can lead to permanent neurological deficits. This review discusses cranial and spinal subdural hematomas, including the history of this complication in the literature. Theories to explain the mechanisms by which hematomas are formed are presented and risk factors are analyzed. The associations between such hematomas and the design of the various needles used for lumbar puncture are evaluated and the most common cranial and spinal locations are discussed. The anatomy of tissues that envelop and contain chronic subdural hematomas are described and the various neurological alterations that can develop are mentioned. Finally, diagnostic imaging options and corrective surgical techniques are reviewed.

Anesthesia, Epidural↗
PubMed2001

In vivo changes after mechanical injury.

Chondrocytes undergo apoptosis in response to mechanical injury in vitro. The current clinical study correlates arthroscopic and magnetic resonance imaging results with biopsy specimens of cartilage from patients with knee injury. Twenty patients were evaluated at a mean 2.7 months after acute knee injury. The mean age of the patients was 32 years and the mean weight was 83 kg. Cartilage lesions were graded separately on magnetic resonance images and arthroscopy in a blinded manner. During arthroscopy, a 1.8 mm diameter biopsy specimen was obtained from the edge of cartilage lesion. The biopsy specimen underwent histologic examination by safranin O staining and detection of chondrocyte apoptosis by the presence of deoxyribonucleic acid fragmentation. There was a positive correlation in 50% (10 of 20) when the presence or absence of cartilage lesions by magnetic resonance imaging was correlated with arthroscopy. All cases of partial thickness or full-thickness cartilage loss that were seen by arthroscopy also were detected by magnetic resonance images. Apoptotic cells were significantly more numerous in biopsy specimens from lesions compared with control biopsy specimens. The findings of reduced cell viability attributable to apoptosis may have profound implications for cartilage repair. This opens potential therapeutic avenues for the treatment of posttraumatic cartilage lesions through apoptosis prevention.

Adult↗
PubMed1997

[Memory disorders in epileptic patients. A study of pre-postsurgical follow-up].

In general terms, epileptic patients with temporal lobe epilepsy (TLE) show mnesic deficits. In the case of medically intractable epilepsy (around 20%) the neurosurgery intervention is a widely accepted treatment. The cognitive effects of surgery have been reported in last years; they emphasize the mnesic positive changes of contralateral area. In the same sense they have reported a negative change on mnesic modality in ipsilateral area. This paper present a study in which the mnesic deficits of twenty eight pharmaco resistant epileptic patients have been evaluated and followed up. These patients have been submittes to a surgical treatment at the Epilepsy Surgical Unit of the Hospital de La Princesa (Madrid). The assessment pre and postoperative tested six months apart. The most common cognitive deficit affect bimodally to mnesic functions: so in the verbal as in the visospatial modality. This deficit correlated with the years epilepsy. Meanwhile, the following up study indicates that a relevant numbers of these patients show an improvement in the function of the contralateral hemisphere with respect to the area surgically treated. This finding probably is the consequence of seizure free.

Adolescent↗
PubMed1996

Inhibitory neurons in the human epileptogenic temporal neocortex. An immunocytochemical study.

Immunocytochemical methods were used to study alterations in inhibitory neuronal circuits in human neocortex resected during surgical treatment of intractable temporal epilepsy associated or not with brain tumours. The epileptogenic cortex was characterized and divided into spiking or non-spiking zones by intraoperative electrocorticography (ECOG). The resected cortex was cut into blocks, sectioned and stained immunocytochemically for visualization of glutamic acid decarboxylase (GAD), the calcium-binding protein, parvalbumin (PV) and glial fibrillary acidic protein (GFAP). A variety of alterations in cortical neuronal circuits as revealed by immunocytochemical and histological methods were found. Similar alterations in inhibitory neuronal circuits appear to occur independently of the primary epileptogenic site and pathology associated with epilepsy, which suggests that there is possibly a common basic underlying mechanism that leads to seizure activity. These changes were apparently unrelated to ECOG findings at surgery, which bring into question the value of the use of interictal epileptic discharges recorded by ECOG to guide cortical resections. The most conspicuous and common change was the loss of chandelier cells. The finding that these cells are among the most vulnerable types of GABAergic interneurons in the epileptogenic temporal cortex indicates that they might be of great functional importance, since the axon terminals of chandelier cells are likely to exert powerful regulation of impulse generation in cortical pyramidal cells. Therefore, these cells might represent a key component in the aetiology of human epilepsy.

Adolescent↗
PubMed1991

Trans-fissural or trans-sulcal approach versus combined stereotactic-microsurgical approach.

The combined stereotactic-microsurgical approach has been used mainly to allow the removal of small subcortical lesions, determining their location and the route to be followed. In our experience, this approach has been most useful in 5 cases of small paraventricular AVMs and another 6 small deep-seated tumoural lesions. Since the availability of MRI, we have systematically applied Yasargil's proposal to perform dissection of the cisterns or sulci to reach a lesion with minimal or no injury to normal neuroanatomy. Assisted by Computer Aided Design software, we can superimpose the MR images with those provided by conventional or digital angiography (mainly the venous phase). MRI allows us to select a route or pathway through a sulcus, and angiography helps us in locating it on the brain surface. We have applied this technique systematically during the past year, and can report 20 cases (1 AVM, 12 tumoural lesions, 1 abscess and 6 haematomas). This trans-fissural or trans-sulcal approach has allowed us resection with minimal surgical damage, after a prompt and precise location. We think that both methods are not mutually exclusive, although the trans-sulcal approach is more adequate because of less discomfort for the patient, the smaller cerebral parenchyma injury and greater anatomofunctional information for the surgeon.

Astrocytoma↗
PubMed1991

The immediate and long-term effects of mannitol and glycerol. A comparative experimental study.

A prolonged experimental situation of focal vasogenic oedema, producing mild intracranial hypertension, was developed. The aim was to study the immediate and long-term effects of repeated infusions of mannitol and glycerol on intracranial pressure (ICP) and cerebral blood flow (CBF). Eighteen goats were operated on twice to implant: an epidural latex balloon in each cerebral hemisphere to measure ICP; an electromagnetic flowmeter around both internal maxillary arteries (the only cerebral blood input), after tying the extracranial branches, to measure the CBF; and two femoral catheters to measure blood pressure (BP) and for intravenous infusion (IV). Three groups of 6 goats each were formed: A) control; the BP and bilateral ICPs and CBFs were recorded under basal conditions and every 4 hours for 3 days after a cold injury (CI) was provoked; B) 20% mannitol solution 1 g/kg body weight injected every 12 hr starting at 24 hr post-CI; and C) 10.1% glycerol solution 0.5 g/kg body weight, administered as mannitol. Glycerol, as compared to mannitol, presents the following major differences among its immediate post infusion effects: a lesser decrease in ICP, but no rebound phenomenon; lesser elevation of BP; CBF increases more gradually and constantly. Long-term effects with mannitol consisted of a rebound phenomenon observed in ICP during the last 12 hr. In all 3 groups, it was observed that CBF increases in relation to the ICP level.

Animals↗
PubMed1990

[A comparative study of myelography and CAT in patients with lumbo-sciatica].

One hundred patients with acute lumbo sciatica symptoms probably due to disc hernia, have been studied. A CT scan and a myelography was performed in all patients. The clinical and radiologic (myelography and CT scan) findings have been evaluated in three categories based on their intensity and a correlation between these three parameters has been performed. Our results show a positivity of 94% in the clinical signs, 87% in the myelography findings and 88% in CT scan findings. The correlation results show that in very severe lumbo sciatica syndromes there is a greater positivity in the myelography than in CT scan findings and that there could be big radiologic changes without a clear clinical repercussion.

Acute Disease↗
PubMedDate not supplied

Selective changes in the microorganization of the human epileptogenic neocortex revealed by parvalbumin immunoreactivity.

The microanatomy of the human lateral temporal cortex removed from patients with intractable temporal lobe epilepsy was studied using correlative light and electron microscopic immunocytochemical methods for the localization of the calcium-binding protein parvalbumin (PV). PV immunostaining was mainly used to label a subpopulation of powerful cortical inhibitory interneurons that have been shown to be lost at epileptic foci in certain animal models of epilepsy. In the human neocortex with normal appearance, we identified the same local neuronal circuitry as in the normal monkey cortex, but in some regions of the same cortex, a fine disorganization of neuronal circuits (loss of inhibitory neurons and presumptive thalamocortical terminals) was found. This abnormal circuitry may interfere with normal cerebral activity in epileptic patients. These results also indicate that PV immunoreactivity can be a useful tool to study normal and abnormal synaptic circuits in the human cerebral cortex.

Adolescent↗
PubMedDate not supplied

[A study of the motor and sensory cortex using functional magnetic resonance: tasks of active and passive movement].

INTRODUCTION AND OBJECTIVE: The objective of this study was to locate the rolandic area (pre- and post-central) by means of functional magnetic resonance imaging (FMRI) and define its correspondence on a Talairach map, whilst active and passive movements of the dominant hand were performed. MATERIAL AND METHODS: Ten healthy volunteers were found, 6 men and 4 women, of an average age of 26 years (range 22-33). Two appropriate tasks were designed: one involving active and one passive movement. The examination was carried out using a 1.5 Tesla (General Electric) MRI apparatus. An echo-sequence of planar echo-gradient (BOLD technique) was used, making sagittal and axial planes, parallel to the AC-PC line (anterior commissure-posterior commissure). Subsequently an anatomofunctional Talairach map was drawn for each subject, to include the information obtained on FMRI. RESULTS: In all subjects central activity was detected in the rolandic area during the tasks involving selected active and passive movements. Overlap was seen between the pre- and post-rolandic areas with both types of tasks. CONCLUSION: There is good correlation between the image obtained of motor-sensory activity in the rolandic zone and the Talairach anatomofunctional map.

Adult↗